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Pennsylvania rates for HCPCS 90647

Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $32.36 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $32.36 / $57.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $30.20 / $33.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $38.02 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $29.51 / $29.51
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $18.20 / $24.55
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $32.36 / $138.04
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $57.54
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $29.51 / $53.70
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $23.44 / $53.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $38.02 / $46.77